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Electrical Nerve Stimulation for Chronic Pain

Treatment Overview

Electrical nerve stimulation is a procedure
that uses an electrical current to treat
chronic pain. Peripheral nerve stimulation (PNS) and spinal cord stimulation (SCS) are two types of electrical nerve stimulation. In either, a small pulse generator sends electrical pulses to the nerves (in peripheral nerve stimulation) or to the spinal cord (in spinal cord stimulation). These pulses interfere
with the nerve impulses that make you feel pain.

Nerve stimulation is done in two steps. To see if it will help your pain, your doctor will first insert a
temporary electrode through the skin (percutaneously) to give the treatment a
trial run. The electrode is connected to a stimulator that the patient can control. If the trial is successful, your doctor can
implant a permanent stimulator under your skin. This is typically done using a
local anesthetic and a
sedative. The stimulator itself is implanted under
the skin and the small coated wires (leads) are
inserted under the skin to the point where they are either connected to nerves or inserted into the spinal canal.

After
this outpatient procedure is complete, you and your doctor determine the best
pulse strength. You are then told how to use the stimulator at home. A typical
schedule for spinal cord stimulation is to use it for 1 or 2 hours, 3 or 4
times a day.

When in use, electrical nerve stimulation creates a
tingling feeling.

What To Expect After Treatment

You will have a small incision that you
should keep clean and dry until it heals.

Why It Is Done

This treatment may be done for people
with severe, chronic pain who have:

Electrical nerve stimulation is typically considered
investigational for various other conditions, including
multiple sclerosis, paraplegia, and intractable
angina.

How Well It Works

There isn't a lot of evidence to show how well spinal cord stimulation works. It seems to help certain types of chronic pain, such as failed back surgery syndrome and complex regional pain syndrome.footnote 1 Spinal cord stimulation may also help chronic low back pain.footnote 2

Some researchers have reported that
more than half of people receiving spinal cord stimulation for chronic low back and leg pain, ischemic leg pain (for example, from peripheral arterial disease), or complex regional pain syndrome have pain
reduction or relief.footnote 3

There is some evidence that peripheral nerve stimulation helps certain types of chronic pain, such as peripheral nerve pain and pain after surgery. Studies so far have been small.footnote 4

Initial pain relief is often followed by a
gradual decline in effectiveness. Apparently, this is caused by the body's increasing
tolerance to the treatment.

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